Mental disorders in the developing worldBMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6945.1716a (Published 25 June 1994) Cite this as: BMJ 1994;308:1716
- L W Dunn,
- T O Adebowale,
- C Umapthy,
- I B Chaudry,
- S D Yangye,
- Y A Rahimi,
- R Omoigui,
- D Dighi-Deo,
- M N Siddiqi,
- P U Ikwuagwu,
- G Festumberhan,
- J A Ngowi,
- O Olayinka,
- D H Pepple,
- F M Ibitoye,
- O Obikoya
- Department of psychiatry, University of Manchester c/o T O Adebowale, Registrar in psychiatry, Ashworth Hospital, Maghull, Liverpool L31 1HW.
EDITOR, - The issues raised by Melanie Abas and Jeremy Broadhead, particularly the suggestion about the use of local resources in developing intervention programmes, are relevant to mental health care delivery in the developing world.
Many developing countries, however, have other major health problems related to poverty and ignorance, besides those shared with the more developed countries. This makes generalisation of health priority statistics meaningless, and such issues should be left to be determined locally. It is also unlikely that concentrating on minor disorders will improve the image of psychiatric services among either the politicians or the populace, whose felt need is likely to be different, irrespective of beliefs about causation.
Most developing countries are still striving to establish a functional primary health care structure. Hence, observable deficiencies in the mental health component only mirror the state of primary health care in general, rather than a specific inadequacy of mental health training. Attention should be paid to the development of a solid primary care framework, with international support.
Alternative practices also need to be carefully studied and evaluated, and those found harmless and effective should be encouraged, to ease the burden on meagerly resourced mental health services. Useful collaboration can be established with such practitioners as a way of monitoring their practices.
These measures, along with Abas and Broadhead's suggestions, will go a long way to making essential mental health care not only available but also acceptable, accessible, and affordable in most developing countries.
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